Ebola: More Special Tx Units Needed

U.S. requires national readiness plan for Ebola and future disease outbreaks.

WASHINGTON -- The U.S. needs more specialized units and more medical professionals trained to deal with Ebola and future outbreaks of emerging infectious diseases, a congressional subcommittee hearing was told.

The four such units now in operation have fewer than 10 usable beds, according to Jeffrey Gold, MD, chancellor of the University of Nebraska Medical Center in Omaha.

"What has become obvious from this Ebola crisis is that a national readiness plan is absolutely necessary," Gold told the oversight and investigations subcommittee of the House Energy and Commerce Committee.

Gold's institution runs one of the four, the biocontainment unit at the Nebraska Medical Center. The others are at Emory University Hospital in Atlanta, the NIH Clinical Center in Bethesda, Md., and St. Patrick Hospital in Missoula, Mont.

"We have the expertise and know-how to contain Ebola and other infectious disease threats," Gold said. "However, in order to do this we must ensure that our nation's healthcare professionals are adequately trained, properly equipped, and rigorously drilled."

The hearing is the second held by the subcommittee to assess the nation's Ebola response and members echoed several themes from that session, including banning travel from West Africa and quarantining returning healthcare workers.

Several members also questioned the role of Ron Klain, the so-called Ebola Czar appointed in mid-October by President Obama.

Klain was asked to appear but declined, subcommittee chairman Tim Murphy (Rep.-Penn.) told the hearing. It appears that Klain is "missing in action," he said.

CDC Director Tom Frieden said he was open to any suggestion that would increase the safety of Americans, but added he thinks a complete travel ban might "paradoxically" increase the risks rather than mitigate them.

The current "layered" system -- screening when people leave West Africa and more screening when they enter the U.S., followed by various forms of monitoring -- is working well, he said.

Roughly 1,500 people have been monitored after arriving and less than 1% have been lost to follow-up, including some who officials found had left the country again. While some have reported symptoms and been transported to hospitals, none has had Ebola, Frieden said.

A travel ban, he said, might result in authorities being unable to track people coming from the region through other countries. Such a ban might hamper relief efforts by making it harder for aid workers to get in and out of West Africa.

That's an important concern, argued Ken Isaacs, vice president for programs and government relations for the missionary group Samaritan's Purse, of Boone, N.C.

While some have argued that a 21-day quarantine period on return is a disincentive for healthcare workers to West Africa, Isaacs said: "It would be much more of an onerous challenge to convince personnel to go if they did not have assurance of their flight home."

And he noted that only two airlines are currently flying to Liberia. "If the commercial flights come to a halt, what is the back-up plan?" he asked.

Isaacs called for a "humanitarian air bridge" that would allow personnel and supplies to get to West Africa.

But he also said travel restrictions should be considered, pointing out that completely free movement has the potential to spread the virus -- not necessarily to the U.S. with its robust public health system -- but to nations like India and Pakistan.

"What would it mean to see the virus spread in these densely populated countries where public health systems are wholly inadequate to contain the outbreak?" Isaacs said.

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